OBJECTIVES: Among patients at high risk for coronary heart disease (CHD) LDL-C remains the primary lipid treatment target. However, HDL-C and triglycerides (TG) have also emerged as modifiable risk factors (RF). This study assessed the attainment of multiple recommended lipid levels among patients receiving lipid modifying therapy (LMT). METHODS: A retrospective clinical chart review of patients treated in primary care and hospitals was conducted in Spain. High CHD risk patients (identified as patients with CHD/CHD equivalent, or 2+ CHD RF) who had full lipid panels 12 months pre-LMT (baseline), and 12-36 months post-LMT initiation (follow-up), were included. Target levels for LDL-C were defined as per NCEP ATP III guidelines. Recommended levels for HDL-C were >40mg/dL for men and >50mg/dL for women, and <150mg/dL for TG. RESULTS: We identified 556 high CHD risk patients, mean age 63.6 (SD10.6) years and 55.9% patients were male.  Ninety-five percent had initiated statin mono or combination therapy. Baseline mean values for LDL-C and HDL-C were 159.5mg/dL (SD38.4) and 52.3mg/dL (SD16.4), respectively. The median TG level was 140mg/dL (IQR: 104-198 mg/dL). The reductions in mean LDL-C, HDL-C and TG from baseline were 26.4%, 0.1% and 8%, respectively. At follow-up, of the total patients with LDL-C not at goal (48.9%), 47.1% had only LDL-C not at goal, 52.9% had both LDL-C not at goal and HDL-C and/or TG not at goal, and 19.4% had all three lipid components not at goal. CONCLUSIONS:In this cohort of mostly statin-treated high risk patients, barely half of them had achieved LDL-C target levels 12-36 months after LMT initiation. Among those with LDL-C not at goal, about 53% of patients experienced HDL-C and/or TG also not at goal indicating high prevalence of multiple lipid disorders.